Syphilis guide

Syphilis signs and symptoms


While syphilis can be silent for years, its symptoms typically occur in the following three stages, with symptoms and complications becoming more serious over time. Caught early, syphilis can be cured. That's why getting tested is so important.

Primary stage syphilis symptoms (within 2-3 weeks after exposure)

Common

  • No obvious symptoms (a painless sore could be small or hidden)
  • A single sore (or chancre) that's round, firm and painless and can appear wherever the body was first infected (vagina, penis, anus, rectum or the mouth area). The sore may be internal – inside your throat or anal canal – so you may not know you have it.

Note: The sore may seem to heal without treatment within three to six weeks. But, without treatment, the infection will potentially advance to the more serious secondary stage.

Uncommon

  • Swollen lymph glands (groin, armpit or neck)
  • Multiple round, firm and painless sores
  • Skin rash (rough, red or reddish-brown spots, usually on the soles of feet or palms of hands)

Secondary stage syphilis symptoms (within 2-12 weeks after primary stage symptoms)

People who don't get treated for syphilis in its primary stage generally stay infected with the secondary stage for up to one year. As in the primary stage, secondary stage sores may go away without treatment, but the syphilis infection will continue to advance and spread through the bloodstream.

Common

  • Swollen lymph glands (groin, armpit or neck)
  • Headaches and fatigue
  • Sore throat
  • Skin rash

Uncommon

  • Sores on the vulva, vagina, penis, anus, rectum or mouth area
  • Moist, wart-like patches in skin folds or on the genitals (condylomata lata)
  • Loss of appetite and unintended weight loss
  • Fever and chills
  • Muscle aches
  • Hair loss

Latent stage syphilis symptoms (symptoms may be hidden for up to 30 years)

Common

  • No obvious symptoms

Uncommon

  • Swollen lymph glands (groin, armpit or neck)
  • Headaches and fatigue
  • Sore throat
  • Sores on the vulva, vagina, penis, anus, rectum or mouth area
  • Moist, wart-like patches in skin folds or on the genitals (condylomata lata)
  • Loss of appetite and unintended weight loss
  • Fever and chills
  • Muscle aches
  • Hair loss

Rare

  • Muscle weakness and lack of coordination (walking can become difficult)
  • Problems with internal organs (brain, heart, kidney or liver functions)
  • Bone or joint deformities
  • Numbness or paralysis
  • Blindness
  • Impaired speech
  • Dementia (memory loss, difficulty concentrating, impaired judgment)

Last reviewed by Lisa Oldson, MD, January 2011.

Lisa Oldson, MD

STD expert

"The first thing I tell a patient about STDs is that if you're worried about one STD, you should probably worry about all STDs. In other words, if you had unprotected sex and you're worried about a possible HIV exposure, it's important to understand that hepatitis can be spread in the same fashion...ditto for chlamydia, gonorrhea, herpes and syphilis."

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